Demographic and clinical characteristics among Turkish homeless patients presenting to the emergency department

Abstract

ObjectiveSince the homeless are at greater risk of encountering health problems than the general population, the reasons for and incidence of their presentations to emergency departments also vary. The purpose of this study was to determine the sociodemographic and clinical characteristics of Turkish homeless patients who brought to the emergency department by ambulance.Materials and methodsThe records of homeless adult patients brought to the ED by 112 emergency service ambulance teams over a 1-year period from January to December, 2014, were examined retrospectively.ResultsThirty-six (21.56%) of the homeless patients enrolled in the study presented due to trauma, and 131 (78.44%) due to non-traumatic causes. One hundred thirty-seven (82.04%) of the total patient group were male. The mean age of the non-trauma patients was 47.3 ± 15.2 years (range, 18–81 years), and the mean age of the trauma patients was 36.9 ± 14.4 years (range, 18–63 years). The most common reason for presentation among patients presenting to the emergency department for non-trauma reasons was clouded consciousness (n = 39, 23.35%), followed by general impaired condition (n = 26, 15.57%), respiratory difficulty (n = 25 14.97%) and abdominal pain (n = 21, 12.57%). The most common reason for presentation among trauma cases was traffic accidents (n = 13, 7.78%), followed by sharp implement injury (n = 9, 5.39%). Four (2.4%) homeless patients died in the emergency department, three (%1.8) homeless patients discharged from the emergency department, and the remaining 160 (95.8%) were admitted to the hospital.ConclusionHomeless patients may present to the emergency department due to traumatic or non-traumatic causes. Admission levels are high among these patients, who may have many acute and chronic problems, and appropriate precautions must be taken in the management of these subjects in the emergency department.

Profile of homeless people in emergency departments

“…This is not a solely economic issue, but also a problem of patient exposure to cumulative doses of ionizing radiation [ 30 ]. These results differ from those reported by Yeniocak et al [ 17 ], where homeless patients admitted for trauma as well as for non-trauma-related reasons, had radiological examinations performed as standard. The percentage of CT scans performed was 3 times less than all X-ray examinations performed.…”

“…No trend in the seasonal nature of admissions is also confirmed by Brown et al [ 16 ]. On the other hand, Yeniocak et al [ 17 ] pointed out a clear seasonal variation in the number of admissions of injured homeless patients. The vast majority of admissions of such patients occurred during the summer months, which is associated by the author with the increased presence of homeless people on the streets and thus a greater likelihood of exposure to injury.…”

Homelessness and the use of Emergency Department as a source of healthcare: a systematic review

“…Respiratory conditions contributed between 1.8% of ED attendance, in a study using national population data from the NHAMCS database, [ 40 ] to 15% in a study evaluating data of those brought by ambulance and non-trauma-related attendance [ 38 ]. Three studies reported both PEH and non-homeless data, producing RRs which ranged from 0.63 [ 40 ] to 1.01 [ 26 ].…”